Treatment of chin
If the diagnosis of CIN is confirmed, local excision, laser destruction, cryodestruction or electrocoagulation of the lesion focus is usually performed. In the absence of treatment, CIN III passes into invasive cancer. Effective therapy of high stages of CIN significantly reduces the risk of developing invasive cancer. Nevertheless, the risk remains higher than the average in the population, so further monitoring of the patient is necessary for at least five years after the end of treatment.
Microinvasive cancer
Patients with microinvasive cancer are shown conization of the cervix (removal of the central part). If the results of the microscopy confirm that all the affected tissues have been removed, further treatment is not required.
• The illustration shows ulceration and hemorrhage around the opening of the cervical canal. Such changes are carefully examined in colposcopy, and then appropriate treatment is prescribed.
Symptoms of invasive cancer
Usually the symptoms of invasive cervical cancer include:
• bleeding - can occur after sexual intercourse (postcoital), in the intermenstrual period (intermenstrual) or after the onset of menopause (postmenopausal);
• pathological discharge from the vagina.
In the early stages of the disease, pain syndrome is usually absent.
• Methods of laser surgery using colposcopic equipment can be used to treat CIN. For visualization, pathological areas are stained with special dyes. On the effective surgical treatment and radiotherapy.
Hysterectomy
Surgery is the method of choice for young, physically strong women. The advantages of this method include:
• absence of cicatricial changes and narrowing of the vagina after radiation therapy;
• preservation of the function of the ovaries - if the pathological process does not extend to the ovaries, and they are not removed;
• no risk of developing a new malignant tumor provoked by irradiation in the long-term.
Surgical intervention for cervical cancer consists of radical hysterectomy (removal of the uterus) and excision of pelvic lymph nodes. Cervical cancer tends to germinate in surrounding tissues. Tumor cells can also spread to lymph nodes, for example, located along the major arteries of the pelvis.
Objectives of surgical treatment
The goal of surgical treatment is complete removal of the malignant tumor and part of healthy tissue. Thus, with a radical hysterectomy, the cervix, the uterus, the surrounding tissue, the vaginal vault, and the pelvic lymph nodes are removed. A biopsy of para-aortic lymph nodes can be performed. Patients with metastases or tumors that go beyond the scope of a possible surgical intervention require additional radiotherapy. Young, nulliparous patients with a cancer process prior to the lb stage who wish to remain fertile can undergo amputation of the cervix. In this operation, the cervix is removed along with part of the paracervical (located around the cervix) and the vaginal vault. The remaining part of the vagina is connected to the uterus body and a suture is placed on the lower edge of the uterus to preserve its ability to bear pregnancy. Pelvic lymph nodes can be removed endoscopically. During pregnancy, the patient is carefully observed to avoid the threat of miscarriage, and delivery is by caesarean section. However, amputation of the cervix is not shown to all women, and radical hysterectomy remains the method of choice. The aim of radiation therapy is the destruction of tumor cells, as well as the irradiation of tissues in which the malignant process could have spread. At stages of cancer, which is contraindicated in surgical intervention, as well as with a far-gone process.
Side effects
Side effects of radiation therapy:
• diarrhea;
• Frequent urination;
• Dryness and narrowing of the vagina (this can lead to dyspareunia - painful sensations during sexual intercourse).
Combination Therapy
Recent studies have shown that a combination of radiotherapy and chemotherapy with cisplatin (a platinum-based drug) allows better results than with radiotherapy alone. The prognosis for patients with cervical cancer largely depends on the stage of the malignant process at the time of treatment. If the tumor has spread to the lymph nodes, the five-year survival rate is reduced by half at each stage according to the FIGO classification. Involving para-aortic lymph nodes indicates a significant prevalence of the process - very few patients live longer than five years after diagnosis. Detection of tumor cells in the blood or lymph is a sign of possible involvement of lymph nodes. The degree of differentiation of the tumor (as far as its structure is close to normal tissue) is also of great importance. The prognosis for low-grade tumors is less favorable than for highly differentiated tumors.